Mitral valve repair for infective endocarditis

Omoto, Tadashi; Ohno, Masahiro; Fukuzumi, Masaomi; Ohi, Masaya; Okayama, Takahisa; Ishikawa, Noboru; Kasegawa, Hitoshi; Tedoriya, Takeo

doi:10.1007/s11748-007-0209-4

Cited by 9 publications

(7 citation statements)

References 10 publications

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“…An additional concern related to the use of patches for valve repair relates to the technical challenges associated with the implantation. Omoto and colleagues 30 reported a high rate of reoperations (20%) for patch dehiscence, which was hypothesized to be related to the extensive suture line length in large patches. In the current study, a suture line leak developed in only 1 patient, but no additional patients showed evidence of patch dehiscence.…”

Section: Commentmentioning

confidence: 99%

Long-term Performance of Fresh Autologous Pericardium for Mitral Valve Leaflet Repair

Quinn

Wang

Foster

et al. 2020

The Annals of Thoracic Surgery

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Section: Commentmentioning

confidence: 99%

Long-term Performance of Fresh Autologous Pericardium for Mitral Valve Leaflet Repair

Quinn

Wang

Foster

et al. 2020

The Annals of Thoracic Surgery

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“…Although better feasibility of MV repair has been demonstrated in patients with healed IE than in those with active IE, surgery during the active phase of IE should frequently be selected to prevent additional thromboembolic events, minimize ongoing valvular destruction, and achieve earlier relief of acute volume overload to the left ventricle (LV) caused by mitral regurgitation (MR). 1,2 The combination of autologous pericardial patch repair, artificial chordal replacement, and annuloplasty has enabled complex MV repair, but suture stress on inflamed valve tissues may result in recurrence of MR. 1 If the feasibility of MV repair appears uncertain, based on preoperative echocardiography, it should not be recommended as an elective operation, but may be preferred in patients with active IE and high-risk comorbidities, such as neurological, hematological, or immunological complications. This study reviewed the results of surgery in patients in the active phase of native mitral valve IE.…”

Section: Introductionmentioning

confidence: 99%

Significance of mitral valve repair for active-phase infective endocarditis

Omoto

Tedoriya

et al. 2011

Asian Cardiovasc Thorac Ann

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Mitral valve repair is preferred to replacement in infective endocarditis, but in the active phase, it often requires extensive debridement of infected tissue and complex reconstruction. We investigated 22 consecutive native mitral valve operations during active-phase infective endocarditis. The time from initiation of medical treatment to operation was 16.8 ± 16.4 days. Mitral valve repair was performed in 15 (68.2%) patients, using prosthetic annuloplasty in 14, an autologous pericardial patch in 11, and artificial chordal replacement in 9. Hospital mortality was 9.1% (2 patients), due to subarachnoid hemorrhage and pneumonia. One patient died 26 months after valve replacement due to congestive heart failure. The postoperative left ventricular end-diastolic dimension was significantly smaller (45.7 ± 5.6 vs. 53.3 ± 10.2 mm) and ejection fraction was significantly higher (57.0% ± 14.7% vs. 40.1% ± 8.2%) in patients who underwent valve repair compared to those who had valve replacement. Mitral regurgitation requiring reoperation occurred in 3 patients during follow-up. Mitral valve repair is feasible in active-phase infective endocarditis, and results in improved regression of left ventricular dimensions compared to valve replacement. However, complex mitral valve repair with extensive leaflet resection may not have long-term durability.

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“…Enlarging the AML by autologous pericardial patch 3) and chordae replacement with ePTFE 2) showed good durability. An autologous pericardium fixed with glutaraldehyde is widely used in MV repair for active infective endocarditis in our institute, 4) and restriction or calcification has not been demonstrated by follow-up echocardiography. Combinations of chordae replacement, ring annuloplasty and AML augmentation may increase the feasibility of MV repair for rheumatic MV disease.…”

Section: Discussionmentioning

confidence: 94%

Mitral Valve Repair in a Patient with Myelodysplastic Syndrome

Omoto

Hirota

Ishikawa

et al. 2011

ATCS

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Open heart operations for patients with myelodysplastic syndrome (MDS) are associated with infective and bleeding complications. We report a 67-year-old woman with rheumatic, severe mitral regurgitation and mitral stenosis associated with MDS who underwent a mitral valve (MV) repair. Commissurotomy was performed in the anterior commissure. Autologous pericardial patch treated with glutaraldehyde solution was prepared. The anterior leaflet was completely detached from the posterior to the anterior commissure. The anterior leaflet was augmented by autologous pericardial patch treated with glutaraldehyde solution and three pairs of artificial chordae were implanted. Postoperative transesophageal echocardiography showed an increase in the MV orifice and less than trivial mitral regurgitation. Two years after the operation, the patient has normal sinus rhythm with no deterioration of the MV lesion by transthoracic echocardiography. Although the feasibility of MV repair is low in patients with restrictive pathology due to rheumatic disease, MV repair may be preferred in patients with MDS.

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Mitral valve repair for infective endocarditis

Abstract: MV repair is feasible in patients with both active and healed IE. MV repair preserves better LV function and structure postoperatively.

Cited by 9 publications

References 10 publications

Long-term Performance of Fresh Autologous Pericardium for Mitral Valve Leaflet Repair

Long-term Performance of Fresh Autologous Pericardium for Mitral Valve Leaflet Repair

Significance of mitral valve repair for active-phase infective endocarditis

Mitral Valve Repair in a Patient with Myelodysplastic Syndrome

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